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NPI 1518922129

NPI 1518922129 : JASON R LEMON PA : LOUISVILLE, KY

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General NPI Number Information
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    NPI Number           |    1518922129
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    Entity Type          |    Individual 
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    Provider Name        |    JASON R LEMON PA
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/18/2006
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    Last Update Date     |    08/05/2016
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Provider Practice Location Address
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    Address Line         |    9880 ANGIES WAY SUITE 250
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    City                 |    LOUISVILLE
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    State                |    KY
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    Zip                  |    40241-2851
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    Country              |    US
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    Telephone            |    502-394-6340
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    Fax                  |    502-394-6340
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Provider Business Mailing Address
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    Address Line         |    PO BOX 776351 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60677-6351
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    Country              |    US
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    Telephone            |    502-588-9490
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    Fax                  |    502-272-5116
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    PA467
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    License Number State |    KY
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